Beer, bongs and baby boomers: the unlikely tale of drug and alcohol use in the over 50s

If you ask someone what a typical heavy drinker or drug user looks like, they’re probably more likely to evoke images of Gen Ys with tattoos and piercings than greying baby boomers.

But recent Australian data, outlined in our British Medical Journal editorial today, shows rates of alcohol and drug use are actually decreasing among younger age groups, while increasing dramatically in people over the age of 50.

Not only is there a rise in the proportion of older people who regularly drink at risky levels, there are also more older people using cannabis.

Older Australians today also have more disposable income than in previous generations, making access to alcohol and drugs more affordable.

What does the evidence say?

Our research, using data from the National Drug Strategy Household Survey, shows high-risk drinking (11 or more standard drinks on a single occasion) in the over 50s increased significantly between 2004 and 2013. People living in regional or remote areas or who smoke tobacco were more likely to drink this way.

In 2016, 11.9% of 50-59 year olds drank at high-risk levels at least yearly (up from 9.1% in 2013). A total of 5.8% did so at least monthly (up from 4.1%).

Cannabis use among the over 50s more than doubled between 2004 and 2013, from 1.5% to 3.6%. Unmarried men who smoked, drank alcohol, and used other drugs were particularly likely to use cannabis.

There is little reliable data on other illicit drug use in older people. But our data shows older people are using more pharmaceuticals, like sedatives and opioids, than before.

And in 2016, 4.1% of 50-59 year olds and 4.5% of people 60 and over used pharmaceutical drugs for non-medical purposes.

Older people often use pharmaceuticals to treat pain (both physical and emotional) or sleep problems. This can also result in balance problems, falls/injuries, reduced ability to function, and even death.

So older people who use alcohol and/or drugs may be more likely to have: falls and other injuries, diabetes and cardiovascular disease, mental health problems (including suicide), obesity, liver disease, early-onset dementia and other brain injury, sleep disorders, and blood borne diseases.

Not all older people have problems with drugs and alcohol

Not all older people who use alcohol and/or drugs have problems. Older people, like other age groups, use alcohol or drugs in many different ways and for many different reasons, as we show with this “typology of older users”:

maintainers continue with their previously unproblematic use as they get older. But age-related changes (like those already outlined) result in increased harms later in life

survivors begin using alcohol/drugs early in life. They have a long history of substance use problems that persist into older age and this often results in other physical and/or mental health problems

Older people may also be reluctant to seek help because of embarrassment, logistical problems (like a lack of transport), inappropriate treatment services for older people, or they do not know where to turn for help.

To combat these problems, we developed a free guide to preventing and reducing alcohol and drug related harm among older people for health and welfare professionals.

What needs to change

Health-care services and the aged care sector need to work better together to prevent problem substance use among older people. They also need to provide age-appropriate treatment and harm minimisation services to people who need them.

Clinicians also need to better identify and treat alcohol, cannabis, and prescription drug misuse in their older patients.

Finally, we need more research into the best approaches for helping older people with substance use problems.

If you would like to talk to a professional about your own or someone else’s alcohol or drug use, contact the free Alcohol and Drug Information Service in your state or territory.

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About Drink Tank

An initiative of the Foundation for Alcohol Research and Education (FARE), Drink Tank aims to generate meaningful commentary and debate about alcohol policy, and to provide a platform for all members of the Australian community to share their views and concerns.